QM Case History: Triglycerides – Lower to Prevent Heart Disease

‘Tom’ asks: How Much Do I Have to Change to Get to Peak Health?


Everybody wants Peak Health. Who wouldn’t? But everyone wants it at the cheapest possible price. I suppose this is human nature. I am always getting the question: How much do I have to change or give up to get to Peak Health?

I don’t know the answer in advance. But, using Quantitative Medicine I can determine it. There are many key numbers that drive health, and triglycerides, which is basically circulating fat, is an important one. In fact, for heart disease, it used to be the most important one, but got shoved aside when the ‘lowest LDL cholesterol at all costs’ craze hit 20 years ago.

Overall LDL cholesterol is unimportant. Since you might think you heard that one wrong, let me repeat: Overall LDL cholesterol is unimportant. Your body will make the LDL it thinks is optimum. Meddling with it always has negative consequences. What is very important, though, is LDL particle size. If it is too small, called pattern ‘B’, it tends to get behind arteriy walls and cause heart disease. If it is big enough, known as pattern ‘A’, it can’t, and you are at low risk.

So a key health question is: “How do I get pattern “A”?” It turns out that if triglycerides are below a certain level, you will get pattern “A”, and if above it, pattern “B”. But what is this magic level? Well, that’s the big question. If you know the right level, you could, in principle, give up just enough of your favorite starchy food, or exercise just a bit harder, and maintain that triglyceride number below your personal key level, and you would then get the heart disease sparing “A” pattern. Of course, you should actually push safely beyond the critical threshold. Things aren’t quite this black and white.

Figuring out that key level is easy to do if you use principles from Quantitative Medicine. Here is an example from my practice.

QM Example Panel

 The patient, whom we’ll call Tom, ‘presented’ with a very high and very unhealthy triglyceride level, well over 200. His particle size pattern was, not surprisingly, “B”, indicating high risk for heart disease. Tom was very committed, modified his diet, began a serious exercise program, and rapidly drove his triglycerides below 100. His pattern flipped to an “A”. Great. You can see this on the right hand graph, where his triglycerides in late 2005 went rapidly down to around 75 by March 2006. On the left hand graph, he popped to an “A” around the same time.

But Tom wanted a ‘bargain’, so he slacked off a bit and hoped for the best. His triglycerides crept up to around 125 in late 2006. This was too high for Tom. His pattern flipped back to a “B”. He coasted along for a year like this, with his triglycerides around 125, 150, and his pattern flipping between “B” and the intermediate “AB” range (meaning both little and big particles were observed).

In early 2007, Tom again made efforts to drive his triglycerides down, and by spring, had the number below 100. His particle size flipped back to the desirable “A” pattern. In 2008, Tom again let the triglycerides go up, flipping back to the “B” pattern.

So Tom may not be willing to do it – that is a different matter – but he is certainly well ‘Quantified’. The key triglyceride level for Tom is a little below 100. When he is below 100, he has the healthy “A” pattern size. Above, he heads toward a “B”.

This is Tom’s key level, not mine or yours. Yours could be as high as 150, or as low as 50. Using the principles of Quantitative Medicine, you can figure it out very precisely. You can explore the unique to you interplay between starches and alcohol for example and get a precise description of what would create a stable triglyceride level and thus uniformly large particle LDL pattern.

Why do triglycerides affect particle size so directly? There’s a very good explanation for this. Stay tuned.

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